Urology>>>>>Benign Prostatic Hyperplasia (BPH) and Lower Urinary Tract Symptoms (LUTS)
Question 6#

The following investigations are not routinely recommended for the specialist assessment of bothersome LUTS by NICE (CG97).

A. Flow rate
B. Post-void residual
C. Symptom score
D. Frequency volume chart
E. Ultrasound of renal tract

Correct Answer is E


Answer E

The NICE LUTS guidance 2010 recommends that in the specialist assessment of a patient with LUTS, the clinician should offer: An assessment of general medical history to identify possible causes and co-morbidities, including a review of all current medication (including herbal and over-the-counter medication) that may be contributing to the problem A physical examination guided by symptoms and other medical conditions, an examination of the abdomen and external genitalia, and a DRE (Jones et al., 2010).

Further tests include a flow rate and post-void residual volume measurement as well as a urinary frequency volume chart. Men should be offered information, advice and time to decide if they wish to have PSA testing if; their LUTS are suggestive of benign prostatic enlargement or the prostate gland feels abnormal or they are concerned about prostate cancer.

The guidance only recommends a cystoscopy and/or imaging of the upper urinary tract when there is a history of recurrent infection, sterile pyuria, haematuria, pain or chronic retention.